1.Evaluation and Prediction of Post-Hepatectomy Liver Failure Using Imaging Techniques: Value of Gadoxetic Acid-Enhanced Magnetic Resonance Imaging
Keitaro SOFUE ; Ryuji SHIMADA ; Eisuke UESHIMA ; Shohei KOMATSU ; Takeru YAMAGUCHI ; Shinji YABE ; Yoshiko UENO ; Masatoshi HORI ; Takamichi MURAKAMI
Korean Journal of Radiology 2024;25(1):24-32
Despite improvements in operative techniques and perioperative care, post-hepatectomy liver failure (PHLF) remains the most serious cause of morbidity and mortality after surgery, and several risk factors have been identified to predict PHLF.Although volumetric assessment using imaging contributes to surgical simulation by estimating the function of future liver remnants in predicting PHLF, liver function is assumed to be homogeneous throughout the liver. The combination of volumetric and functional analyses may be more useful for an accurate evaluation of liver function and prediction of PHLF than only volumetric analysis. Gadoxetic acid is a hepatocyte-specific magnetic resonance (MR) contrast agent that is taken up by hepatocytes via the OATP1 transporter after intravenous administration. Gadoxetic acid-enhanced MR imaging (MRI) offers information regarding both global and regional functions, leading to a more precise evaluation even in cases with heterogeneous liver function. Various indices, including signal intensity-based methods and MR relaxometry, have been proposed for the estimation of liver function and prediction of PHLF using gadoxetic acid-enhanced MRI. Recent developments in MR techniques, including high-resolution hepatobiliary phase images using deep learning image reconstruction and whole-liver T1 map acquisition, have enabled a more detailed and accurate estimation of liver function in gadoxetic acid-enhanced MRI.
2.8. Learning Assessment and Good Practice (2)
Shoichi ITO ; Hitoaki OKAZAKI ; Hiroyuki KOMATSU ; Hiroshi NISHIGORI ; Yasushi MATSUYAMA ; Masanaga YAMAWAKI ; Makoto KIKUKAWA ; Ikuo SHIMIZU ; Mariko NAKAMURA ; Shohei MITANI
Medical Education 2023;54(2):182-186
In the 2022 Model Core Curriculum for Medical Education in Japan, "Chapter 3, Educational strategies and assessment" section II. "Learner Assessment," consists of three parts : II-1. Approaches to learner assessment, II-2. Assessment methods, and II-3. Questions about learner assessment. Based on the idea that "the way assessment is done varies from institution to institution," the answer to the "Question" is deliberately not included. We hope that readers will refer to this chapter when planning learning assessments in curriculum development while considering the curriculum's background and context.